Impact of chronic liver disease on outcomes of hospitalized patients with COVID-19: A multicentre United States experience

Liver Int. 2020 Oct;40(10):2515-2521. doi: 10.1111/liv.14583. Epub 2020 Jul 5.

Abstract

Liver injury has been described with COVID-19, and early reports suggested 2%-11% of patients had chronic liver disease (CLD). In this multicentre retrospective study, we evaluated hospitalized adults with laboratory-confirmed COVID-19 and the impact of CLD on relevant clinical outcomes. Of 363 patients included, 19% had CLD, including 15.2% with NAFLD. Patients with CLD had longer length of stay. After controlling for age, gender, obesity, cardiac diseases, hypertension, hyperlipidaemia, diabetes and pulmonary disorders, CLD and NAFLD were independently associated with ICU admission ([aOR 1.77, 95% CI 1.03-3.04] and [aOR 2.30, 95% CI 1.27-4.17]) and mechanical ventilation ([aOR 2.08, 95% CI 1.20-3.60] and [aOR 2.15, 95% CI 1.18-3.91]). Presence of cirrhosis was an independent predictor of mortality (aOR 12.5, 95% CI 2.16-72.5). Overall, nearly one-fifth of hospitalized COVID-19 patients had CLD, which was associated with more critical illness. Future studies are needed to identify interventions to improve clinical outcomes.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • COVID-19* / mortality
  • COVID-19* / physiopathology
  • COVID-19* / therapy
  • Critical Illness* / epidemiology
  • Critical Illness* / therapy
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Liver Cirrhosis* / diagnosis
  • Liver Cirrhosis* / epidemiology
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / isolation & purification*
  • United States / epidemiology